Provider Demographics
NPI:1093826380
Name:CONDRON, JANET LYNN (MS)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:LYNN
Last Name:CONDRON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 CZACKI ST
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-4301
Mailing Address - Country:US
Mailing Address - Phone:630-243-6728
Mailing Address - Fax:630-243-6728
Practice Address - Street 1:733 CZACKI ST
Practice Address - Street 2:
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439-4301
Practice Address - Country:US
Practice Address - Phone:630-243-6728
Practice Address - Fax:630-243-6728
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01627319OtherBCBSIL